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Utilization Jobs (NOW HIRING)

Centene

Director, Utilization Management

$133K - $247K/yr

Directs the utilization management team to ensure the appropriate application of policy procedures and processes to help support best member outcomes. Oversees and manages Utilization Operations ...

UF Health

Manager, Utilization Review

Gainesville, FL · On-site

Overview The Manager of Utilization Review provides operational leadership and oversight for utilization review activities across the health system. This role is responsible for ensuring clinical ...

Centene

Supervisor, Utilization Management

$75K - $135K/yr

Supervises day-to-day activities of utilization management team. Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future.

UF Health

Manager, Utilization Review

Gainesville, FL · On-site

Overview The Manager of Utilization Review provides operational leadership and oversight for utilization review activities across the health system. This role is responsible for ensuring clinical ...

Summit BHC

Utilization Specialist

Williamsburg, VA · On-site

Utilization Specialist | The Pavilion at Williamsburg Place | Williamsburg, Virginia About the Job: The Utilization Specialist is responsible for reviewing of assigned admissions, continued stays ...

Socket.dev

Manager, Utilization Review

Gainesville, FL · On-site

$125 - $150/hr

Overview The Manager of Utilization Review provides operational leadership and oversight for utilization review activities across the health system. This role is responsible for ensuring clinical ...

New

Acadia Healthcare

Utilization Specialist

Valdosta, GA · On-site

Proactively monitor utilization of services for patients to optimize reimbursement for the facility. ESSENTIAL FUNCTIONS: * Act as liaison between managed care organizations and the facility ...

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Utilization information

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$21

$42

$68

How much do utilization jobs pay per hour?

As of Sep 8, 2026, the average hourly pay for utilization in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What is a utilization specialist?

Utilization specialists are professionals who review and evaluate the necessity, appropriateness, and efficiency of the use of healthcare services, procedures, and facilities. They work closely with healthcare providers, insurance companies, and patients to ensure that care is delivered according to established guidelines and that resources are used effectively. Their goal is to help manage costs while ensuring patients receive the appropriate level of care.

What are some of the common challenges faced by utilization review specialists when assessing medical necessity of services?

Utilization Review Specialists often encounter the challenge of balancing patient advocacy with cost-effective care. They must stay updated on evolving insurance policies and clinical guidelines, which can be complex and change frequently. Additionally, coordinating with physicians and healthcare staff to obtain necessary documentation and clarifying treatment plans can be time-consuming. Strong communication skills and attention to detail are essential to ensure timely and accurate reviews, while also maintaining positive working relationships with clinical teams.

What are the key skills and qualifications needed to thrive as a utilization review specialist, and why are they important?

To thrive as a Utilization Review Specialist, you need a background in healthcare (often as an RN or LPN/LVN), strong analytical skills, and knowledge of insurance and medical necessity criteria. Familiarity with utilization management software, ICD-10/CPT coding, and regulatory guidelines like Medicare and Medicaid is typically required. Excellent attention to detail, critical thinking, and effective communication skills set top performers apart in this role. These abilities are crucial to accurately evaluating patient care needs, ensuring regulatory compliance, and optimizing resource use within healthcare organizations.

What is the difference between Utilization vs Resource Coordinator?

AspectUtilizationResource Coordinator
Primary FocusMeasuring and optimizing how staff time is usedManaging and assigning resources for projects
Required CredentialsOften no specific credentials, but industry experience helpsTypically requires organizational or project management skills
Work EnvironmentCorporate, healthcare, or consulting firmsProject teams, staffing agencies, or departments
Common UsageTracking staff utilization ratesAllocating resources to projects or tasks

Utilization focuses on measuring how effectively staff time is used, often to improve productivity. Resource Coordinator involves actively managing and assigning resources to ensure project needs are met. While related, utilization is more about analysis, and resource coordination is about execution and management.

How to become a utilization reviewer?

To become a utilization reviewer, candidates typically need a background in healthcare, nursing, or a related field, along with knowledge of medical coding and insurance policies. Relevant certifications such as Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS) can enhance job prospects. Strong analytical skills and attention to detail are essential for reviewing medical records and determining appropriate service utilization.
More about Utilization jobs

What cities are hiring for Utilization jobs?

Cities with the most Utilization job openings:

What are the most commonly searched types of Utilization jobs?

The most popular types of Utilization jobs are:

What states have the most Utilization jobs?

States with the most job openings for Utilization jobs include:

Utilization jobs near you
Infographic showing various Utilization job openings in the United States as of August 2026, with employment types broken down into 2% As Needed, 87% Full Time, 9% Part Time, and 2% Contract. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Review

Providence SoCal Shared Services

Torrance, CA • On-site

Other

This job post has expired today. Applications are no longer accepted.

Job description

Utilization Review Rn

Job Type: Travel

Profession: RN

Specialty: Utilization Review

Shift Details: 5x8 Days

Job Order Details: Start Date 09/21/2026 End Date 12/21/2026 Duration 13 Week(s) Float Required: No

Client Details: State CA

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